To ensure that denied, rejected, or underpaid insurance claims are corrected and resubmitted accurately and promptly to maximize reimbursement for healthcare services
The post holder will:
Analyze the rejections
Clarifying the Rejection queries to the Insurance Company
Doing Resubmission production for assigned facility with quality.
Sharing rejection feedback to the Submission team
Sharing rejection feedback to the Approval team
Sharing rejection feedback to the reception team.
Facilities doubt clearing (Coding, insurance Queries)
Monthly team meeting in sharing the ideas regarding insurance rejection.
Sharing rejection updates to medical auditor to share with respective doctor.
Supporting submission team for their queries
Providing justification for reconciliation claims.
College Diploma - Any discipline or related fields.
Coding Certification, CPC - Certified Professional Coder (AAPC)
Proficiency in:
ICD-10-CM (diagnosis codes)
CPT (procedure codes)
HCPCS Level II (supplies, equipment, services)
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